The social organization of structural vulnerability among people who are homeless and use drugs: an institutional ethnography.

AbstractBackgroundMethodsResultsConclusionIn this article, we describe an institutional ethnographic investigation of the housing and homelessness response in one municipality in Ontario, Canada.Drawing on 42 interviews with social service professionals and municipal government employees and 49 interviews with people who are or have been using municipal housing and homeless services (e.g. emergency shelters, mobile healthcare, outreach services, transitional housing), we bring into view some of the inter-institutional and organizational processes that shape housing precarity among people who use drugs.Our research pinpoints specific institutionally-organized processes – i.e. structural vulnerabilities – that expose people who use drugs to housing loss, unsheltered homelessness, and difficulties in re-housing (or homeless chronicity). In many cases, the processes also make people more vulnerable to harms associated with substance use.The specificity of our analysis points toward policy, legislative and institutional reforms that could improve access to justice, health, and housing for people who use drugs. [ABSTRACT FROM AUTHOR]